Low back pain and exercise, what should you be doing? [2022]

pilates low back exercise

Where to start with exercise to help with low back pain.

There is no arguing that exercise is one of the most important factors in beating back pain, as the saying goes motion is lotion.  So what is the best exercise for low back pain that you can do ?

Some of the most common statements we hear in the clinic regarding this topic are:

  • What is the best exercise I can do for my low back.
  • I need a better or stronger core.
  • I need exercises to stretch my hamstrings or hip flexors.
  • Will Pilates get rid of my back pain ?

The answer to these questions ? It depends.

Everybody’s low back pain is different.

The most important area to address before you start exercising is getting a better understanding of what is causing your back pain. So before you start exercising its probably best to find out where you need to start, with the help of your physiotherapist. Check out this post regarding what your first visit to the physio should involve.

Once that’s out of the way then its onto the million dollar question:

What types of exercise are effective in treating low back pain ?

The most common types of exercise that are associated with the treatment of low back pain include:

  • core stability and strength exercises.
  • Flexibility and mobility exercises.
  • Aerobic exercises.

Core stability and strength exercises  for low back pain.

The concept of core stability has been around with us a long time and is still, rightly or wrongly, to be thought as a contributor to back pain issues.

The concept is basically that the back has a muscle system that is responsible for fine control, the inner core,  and one that is responsible for bigger power movements. It was thought that if the inner core wasn’t working effectively it could lead to back pain issues.

From that research it appears that  this type of exercise program can effectively reduce pain. Some studies have reported up to 78% improvement.

However the effectiveness of specific core exercises are enhanced with  what are considered more general strengthening exercises.

Our take away from this is to have the best result we need to mix specific exercises for your problem to more common types of strength exercise.

This can be as simple as using the basics of neutral posture or bracing your abdominals whilst doing squats or any other exercise.

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Who will benefit from core stability exercises ?

Typically i would say those whose pain or symptoms are exacerbated by activities or tests that require an increase in muscle strength at the lumbar spine.

For example if we can reduce or get rid of someone’s pain by using good bracing or core activation techniques then chances are they are a good candidate for this type of rehab.

Other signs they may be a good candidate is if there pain history indicates that their symptoms get worse when they are fatiguing or getting tired in a task . Could be they are lacking strength endurance rather than absolute strength in their core system.

What should you do to strengthen your core muscles ?

There are many different exercises proposed to target the core muscles but the essential components involve either bracing or hollowing the abdominals and  maintaining an “ideal” posture with exercises, read more here  

Once that is achieved then gym based activities, Pilates and specific core exercises become more effective. Our favourites and ones often cited in the literature are the McGill big 4 exercises which you can see in the video below:


Flexibility and stretching exercises and low back pain.

This is also a bit of a hot potato subject due to the contradictory evidence as well as stretching falling in and out of vouge.

However there is evidence that an improvement in lumbar flexibility  has been associated with better range of motion of the spine, which can help to reduce back pain and assist with movement.

There are studies that have shown anywhere from a 30 – 58% improvement in pain and disability with low back pain when its used as part of an exercise program.

Certainly there is evidence to suggest that if the back muscles are working too hard that this can contribute to back pain. In this case stretching or mobility type exercises may help reduce this over activity and  lead to reduced low back pain.

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Aerobic exercise and the benefits for  low back pain.

The easiest and most accessible exercise available to you. Aerobic exercise has consistently been shown to help with low back pain and probably works at various levels including :

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  • Increasing endorphins , your own natural pain killers.
  • Improving blood flow to tissues and joints helping with stiffness.
  • Encouraging movement with low back.
  • Reduce the perception or intensity of pain.
  • Reducing fear of movement , a big contributor to low back pain.

These benefits are more than likely involved with all forms of exercise undertaken. Aerobic exercise is especially potent though. It is as simple as going for a brisk walking or cycling on a static bike and is highly effective.

So what’s the best exercise for you and your low back pain ?

So what we can take from the above research is that most types of exercise have a very positive effect on low back pain.  The most important exercise is the one you enjoy and the one you are going to do and keep doing.  Enjoyment of exercise is an important factor in exercise adherence.

Your low back pain and exercise

However It is important to work out what the priority is with your back. Some people may need more mobility and aerobic fitness in the initial stages before we step up the the core stability or strength phase. Others may be more strength and stability focused.

In truth a good rehab plan for low back pain uses all these modes of exercise in different ways.

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Arana Hills Physiotherapy back pain rehab approach.

We prefer to use a combination of all three exercise methods described. By doing this its easier to create exercise programs that are simple, enjoyable, challenging and easily integrated into your lifestyle.

A typical rehab session for our clients may involve 3- 4 min circuits of 3 exercises : 1 strength,  1 Pilates or core exercises and  1 mobility exercise. All aimed at what we feel will help your low back the best.

These are done in a circuit fashion and once finished its 2-3 minutes of good aerobic exercise.

it may start off as a 15 minute session but the goal is to be able to do this for 45 minutes. Its fun and very effective and covers all the above essentials of exercise for low back pain.

We feel that we build more general and specific low back fitness, mobility and strength.  Giving our clients the ability and confidence to take on the challenges that life throws at them without worrying about back pain.

Exercise has a powerful pain relieving effect use it to your benefit.

If doesn’t matter if you’ve have had long term issues with your back or had a single episode  that’s really slowed you down. Getting the right program makes all the  difference.  you can  book in to see one of our team here

Thanks for reading


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A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain